San Francisco program for uninsured residents to remove transgender exclusions

Nearly two years after a complaint was filed charging that “Healthy San Francisco,” the city’s health insurance program for uninsured residents, is discriminatory because it excludes services for transgender people, city officials are in the process of rectifying the situation and including such services in the program.

Supervisor Scott Wiener and transgender leaders met with The Bay Area Reporter Monday, July 16 and said that city officials are expected to soon sign off on the changes that would allow sexual reassignment services, treatment, and surgery to be covered for transgender patients just as they are now for non-trans patients.

Barbara Garcia, the director of the Department of Public Health, told The Bay Area Reporter that her agency is committed to the changes, but that it would take another year to year and a half before the administrative steps are implemented, due to contracting requirements.

“We’re totally committed to it,” Garcia said.

Wiener introduced a resolution at last week’s board meeting calling on the health department to “provide medically necessary transition-related care for transgender people and to remove exclusions under the San Francisco Health Care Security Ordinance,” or Healthy SF.

Healthy SF is the city’s locally designed and funded universal health care program that was launched in 2007. It currently provides hormone treatment and mental health services to transgender participants, but administratively excludes sex reassignment surgery and denies coverage for certain surgical procedures to transgender people when the same procedures are provided to non-transgender participants, “thus denying transgender residents equal access to necessary health care under this local plan,” Wiener’s resolution states.

For example, a Healthy San Francisco participant diagnosed with breast cancer could have breast reduction surgery covered under the plan, but a female-to-male transgender person could not have the same surgery covered.

Wiener said the costs would be negligible and pointed out that when the city began offering similar benefits to its transgender employees several years ago the actual cost was lower than the projections.

Cecilia Chung, a transgender woman who was former president of the Human Rights Commission and who was recently appointed by Mayor Ed Lee to the Health Commission, agreed.